Zinc deficiency may increase severity of cirrhosis and hepatic encephalopathy, suggests study

A new study published in the Journal of Family Medicine and Primary Care found that higher degrees of hepatic encephalopathy (HE) and more severe cirrhosis are substantially correlated with zinc deficiency. Since liver disease was responsible for 18.3% of the two million liver disease-related deaths worldwide in 2015, there is a significant burden of the illness in India.

A steady decline in liver function, including the generation of clotting factors and other proteins, the detoxification of toxic metabolic products, and the excretion of bile for more than six months, is known as chronic liver disease. A serious side effect of liver cirrhosis that has a high death rate is hepatic encephalopathy. Zinc deficiency has been identified in a small number of studies as a risk factor for the development of HE in individuals with liver cirrhosis and HE. This study was conducted to assess serum zinc levels in patients with liver cirrhosis and HE to look for the association between serum zinc levels and grades of HE.

At a tertiary care facility in Jharkhand, 150 patients with liver cirrhosis and HE participated in a cross-sectional observational research. Every patient was assessed using a clinical examination, history taking, and a questionnaire before being categorized into various WHC grades of HE and CPC classes of cirrhosis. All patients underwent routine imaging scans, blood tests, and morning serum zinc measurements.

Zinc deficiency was seen in the majority of individuals with HE and liver cirrhosis. The link between low serum zinc levels and WHC grades of HE was statistically significant (P <.00001). There were extremely significant variations (P <.00001) in the blood zinc levels across the various groups of cirrhosis. The patients who passed away had a substantially lower mean blood zinc level. Serum zinc and albumin levels were shown to be positively correlated (r =.88, P =.048).

Overall, serum zinc levels were low in individuals with liver cirrhosis and HE, and considerably lower in the individuals with severe grades of HE. Zinc deficiency can contribute to the formation of HE in liver cirrhosis. Serum zinc levels are low in liver cirrhosis, and they are even lower in the more severe classes of cirrhosis. The patients with liver cirrhosis and HE who had low levels of albumin also had low serum zinc, indicating that low serum albumin can serve as a proxy measure for low serum zinc.

Reference:

Kumar, D., Prasad, M. K., Kumar, S., Aziz, T., Prasad, M. L., Sinha, R., Guria, R. T., Kumar, A., Vidyapati, Kumar, S., & Kumar, P. (2024). Serum zinc level in liver cirrhosis with hepatic encephalopathy and its correlation with different stages of hepatic encephalopathy. In Journal of Family Medicine and Primary Care (Vol. 13, Issue 9, pp. 3979–3987). Medknow. https://doi.org/10.4103/jfmpc.jfmpc_537_24